Pre-medicating

PA is new to our family but I don't know why I haven't thought of this possible obvious solution to having a bad reaction at 35,000 feet in the air.

Why not simply pre-medicate? When we have patients who are highly allergic to contrast dye that needs to be given during absolutely necessary medical tests,we give them benadryl and prednisone. The first dose is 12 hours before and then 1 hour before. The dose would depend on what your doctor orders.

There probably is not a more severe and instant reaction than from something given IV. If it can prevent that surely it can prevent PA reactions.

Although nothing in life is 100% sure, it could, along with normal precautions, go a long way to alleviate the fear of flying, so to speak. I spoke with a doctor who said "Sure,it would work"

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Of course, prednisone is not something to be given routinely. It is a vicious drug over long periods of time. But in certain situations---and being 7 miles in the air is one---I think it would help to ease fears.

Ask you allergist. Only your own doctor knows about your particular situation.

Kari,RN

On Mar 5, 2001

hello keri,
I am also a nurse & have always pre-medicated pts. before angiograms, etc.
I will be taking my pa daughter to visit family soon & will be giving benadryl (not sure on the prelone yet) before we fly. I also think it is a great idea for the rare occasions that we fly.
deanna

On Mar 5, 2001

Our allergist has advised against premedicating for the following reason. Benedryl is an anti-histamine and this only suppresses part of the analaphylaxis cascade. She feels that if my child were to have a reaction we might miss some early histamine-related warning signs (if these were masked by an antihistamine) and would not be on high-alert.

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When flying we carry benedryl, EpiPens and an oral corticosteriod (the latter was the allergist suggestion). I have been told that if we are on an airplane and need to use the EpiPen then to use the steroids as well. We don't carry the steroids around with us unless we are travelling.

If it was as easy as using an anti-histamine could we keep out children on anti-histamines for those strssful pnb-filled school days? It would be great if we could.

[This message has been edited by EILEEN (edited March 05, 2001).]

On Mar 5, 2001

Eileen,

You are right about not wanting to keep your child on benadryl all the time. But benadryl AND prednisone(a steroid)--which is what I had said in my original post-- before a flight would work. Have the epi available, of course.

I am an ER nurse in a big city ER with 54 beds. We see lots of everything. Benadryl and steroids are the first line drugs for allergic reactions. We do not always give epi. Generally it is reserved for difficulty breathing or facial/tongue swelling.

The bottom line ,of course, is that you have to do what makes you feel the most comfortable.

Kari,RN

On Mar 5, 2001

Again, I think pre-medicating is the way to go. I probably have not experienced as many reactions as Kari, but working in the ICU, I have experienced many, many reactions to antibiotics, and we always start with benadryl, then the steroids, rarely did we need to give epinephrine. We always continued to observe. But as always, if you trust your doctor, go with what he/she says.
Doctors will often have different treatments. My doctor thinks pre-medicating is a great idea. Good luck, stay safe,
Deanna

On Mar 5, 2001

Both my son and I take an antihistamine daily, not benadryl but zyrtec and I take allegra would this mask symtoms as well? We both have so many enviromental allergies as well and I went into anaphalaxis from allergy shots so I am too paranoid to let him get them. I just bring abottle of Benadrl and two shots for each of us. I will have to get the prednisone too.

On Mar 5, 2001

Kari
What a great idea!!!
I know that I would certainly feel much more comfortable flying!
I'm going to speak to my doctor before I move......we will be driving for over 33 hours and most of the drive will be through "remote and under-serviced" areas.....I've been really nervous and this may just be the answer!

Thanks again!
Sharon (who would love to sleep through that long drive!)

On Mar 5, 2001

Kari,
When you premedicate patients prior to these procedures, what dose of prednisone is used?

Are the patients required to "taper down" the dose at home or is adrenal suppression and all the other nasties associated with rapid withdrawal not an issue in these cases?

I guess I would be hesitant to dose my child with oral corticosteroids without close medication supervision after dosing.

On Mar 6, 2001

There is no need to decrease doses gradually for just pre-medicating. It is only when you are on steroids for an extended period of time you need to worry about this.
Deanna RN

On Mar 6, 2001

Deanna is absolutely right. And I should say again that you would never want your child on prednisone for any length of time. No reputable doctor would prescribe it anyway.

For a flight or long drive, the dosages and times would be up to your doctor. At our hospital, for a planned medical test the meds are given 12 hours,2 hours,and 1 hour before the test. But it is best for your own doctor to do what is right for your particular situation.

Kari

On Mar 8, 2001

I have heard from some adults who have taken prednisone that it makes you feel very weird. Also isn't feeling hyper one of the side effects. I work with animals, that sometimes are treated with pred. for a few days and they definitely show a tendency to become hyper. If so for people, sleeping through the road trip might not be an option.

On Mar 8, 2001

Again, I was talking about one, maybe two doses. We are flying tomorrow and pre-medicating. If you don't want to do it --then don't. Whatever you are comfortable with is what you should do.

Kari

On Mar 9, 2001

I brought this issue up with my child's physican who was- well astounded is a mild way of putting it. She restated that no steroids should be used without full discussion with a medical doctor.

On Mar 9, 2001

As Kari stated, you should talk to your doctor first. You cant get prednisone without a prescription.
Deanna

On Mar 9, 2001

I think we are all aware that corticosteroids can only be prescribed to patients by a qualified medical doctor.

Here is a link to a great web site that documents (in a very user-friendly way) adverse events, contraindications, drug interactions etc., for prednisone and all other drugs.
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